Surgical Outcomes of Selective Laminectomy for Patients With Cervical Kyphosis: A Retrospective Study of 379 Cases

Ken Ninomiya, Kunimasa Okuyama, Ryoma Aoyama, Satoshi Nori, Junichi Yamane, Satoshi Suzuki, Kazuya Kitamura, Ukei Anazawa, Mitsuru Furukawa, Tateru Shiraishi, Seiji Ueda, Masahiro Kato

研究成果: Article査読

1 被引用数 (Scopus)

抄録

Study Design: A retrospective study. Objectives: This study aimed to investigate the impact of cervical kyphosis on patients with cervical spondylotic myelopathy (CSM) following selective laminectomy (SL) regarding posterior spinal cord shift (PSS), and a number of SLs. Methods: We evaluated 379 patients with CSM after SL. The patients with kyphosis (group K) were compared with those without kyphosis (group L). Moreover, groups K and L were divided into subgroups KS and KL (SLs ≤ 2) and LS and LL (SLs ≥ 3), respectively, and analyzed. Receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off value of the C2–C7 angle for satisfactory surgical outcomes, which was defined as a Japanese Orthopaedic Association (JOA) recovery rate of ≥50% in group KS. Results: The average PSS (mm) in group K was smaller than that in group L (.8 vs 1.4; P <.01), but the JOA recovery rate was comparable between the 2 groups. Meanwhile, the mean PSS and JOA recovery rate (%) in group KS was lower than those in group KL, respectively (.3 vs 1.0; P <.01, 35.1 vs 52.3; P =.047). Moreover, the average PSS of group KS (.6) was smaller than those of other subgroups (<.01). In addition, the ROC curve analysis showed that the C2–C7 angle of −14.5° could predict satisfactory surgical outcomes in group KS. Conclusion: Selective laminectomy is not contraindicated for patients with kyphosis, but a larger number of SLs may be indicated for the patients with C2–C7 angles of ≤ −14.5°.

本文言語English
ジャーナルGlobal Spine Journal
DOI
出版ステータスAccepted/In press - 2021

ASJC Scopus subject areas

  • 外科
  • 整形外科およびスポーツ医学
  • 臨床神経学

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